Colorado
The Board of Pharmacy’s Sunset bill SB21-094, which includes several provisions expanding pharmacists’ scope of practice, therapeutic substitution, prescription adaptation, and ability to order long-acting injectables passed the Senate 35-0. The bill was amended by the House Health and Insurance Committee on a vote of 11-2 on May 12 and now advances to the House Finance Committee.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
Gov. Eric Holcomb (R) signed into law House Bill 1468 – Various health matters – Indiana General Assembly, 2021 Session by Rep. Steven Davisson, a broad health care provider bill NACDS supported that included the following provisions that impact pharmacy practice:
- Increases to 8:1 the pharmacy technician-to-pharmacists ratio;
- Allows pharmacy technicians to work remotely performing certain non-dispensing duties including data entry and insurance processing;
- Permits pharmacists, pharmacy students, and pharmacy technicians to administer the COVID-19 vaccine according to a prescription, protocol, or standing order in addition to the 11 other vaccination categories listed in statute;
- Allows pharmacies to transfer unfilled C-II prescriptions;
- Expands therapeutic substitution under a protocol;
- Removes the requirement for shared record-keeping systems for pharmacists that engage in a collaborative practice agreement;
- Delays e-prescribing for controlled substances until January 1, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Board of Pharmacy issued guidance on pharmacy operations under the April 30, 2021, renewed governor’s proclamation of a disaster emergency due to the COVID-19 pandemic. The guidance extends the suspension of certain regulatory provisions established under prior notices through May 30, 2021. As noted in the Board’s response, “… The Board will continue to monitor the situation as additional information is available and make necessary adjustments to provide pharmacy professionals with the guidance needed to navigate the current public health emergency.”
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Missouri
The Department of Social Services HealthNet Division (DSSHD) issued a rule removing obsolete provisions in addition to referencing new provisions establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid. DSSHD also adopted regulations establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid. These rules are effective July 1, 2021, and expire on February 24, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
SB190 by Sen. Nicole Cannizzaro (D) that NACDS and the Retail Association of Nevada support allowing a pharmacist to dispense a self-administered hormonal contraceptive under the standing order passed the Senate 21-0 and was heard in the Assembly Commerce and Labor Committee on May 10.
Also in Nevada, AB177, legislation NACDS opposed filed by Majority Leader Benitez-Thompson (D) that requires pharmacies to post the rights of patients to demand information that at the request of the patient, pharmacies provide written translations on the prescription label in a language other than English. Despite opposition from NACDS and pharmacists, the bill passed the Assembly by a vote of 26-16. It was referred to the Senate where it was amended on May 11th and is awaiting a vote out of the Senate Health and Human Services Committee.
Also in Nevada, SB229, legislation expanding pharmacy collaborative practice agreements that NACDS and the Retail Association of Nevada support passed the Senate 17-4, was heard in the Assembly Commerce and Labor Committee in late April. A second work session was held on May 12. The next step is for the Committee to approve the bill and send it to the full Assembly.
Lastly in Nevada, AB178 by Assemblywoman Hardy allows under certain conditions a pharmacist to fill or refill a prescription in an amount that is greater than the amount authorized by the prescriber but cannot exceed a 30-day supply when a disaster or state of emergency is in effect.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The May 20, 2021, Continuing Education Rules Advisory Committee meeting agenda is now available.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
NACDS reminds members that on March 29 the new Acting Physician General Denise Johnson signed a new standing order for naloxone. All prescriptions using the standing order from former Secretary of Health Levine or former Acting Physician General Braund, and any remaining refills on those prescriptions are null and void.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
On May 6, HB678 by Rep. Phil Cortez (D), overwhelmingly passed the House by a vote of 139-7. HB678, supported by NACDS, allows pharmacists to independently order, and both pharmacists and technicians to administer, all immunizations to anyone 3 years of age or older without a prescription. The bill will now be heard by the Senate Health and Human Services Committee. NACDS members are urged to call their State Senator to ask them to HB678 expanding access to immunizations by permanently removing existing administrative barriers.
Also in Texas, the Board of Pharmacy launched a new podcast for Board news and updates. The first episode covers the November 2020 and February 2021 Board meeting rule adoptions, along with recent Board news and an important scam alert. www.pharmacy.texas.gov/podcast
Laslty in Texas, the Texas Department of State Health Services Commissioner John Hellerstedt is encouraging vaccine providers to order additional COVID-19 vaccines as needed as the state is now receiving about 1.5 million a week. Texas has now administered more than 18.3 million doses of the vaccine. More than 11 million people have received at least one dose, and over 7.9 million are now fully vaccinated. covidvaccine.texas.gov.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Department of Health, Pharmacy Quality Assurance Commission adopted regulations allowing retired pharmacists to apply for a retired active pharmacist license status and practice pharmacy under certain conditions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
For veterinary prescriptions that may not be refilled between May 1, and June 30, 2021 (due to the one-year time limitation on prescriptions), the director of the Department of Consumer Affairs extends an order waiving the California Code of Regulations, title 16, section 2032.1, subdivision (c) to the extent it prohibits a veterinarian from prescribing a drug for a duration longer than one year from the date the veterinarian examined the animal and prescribed the drug, subject to the condition that any such prescription may be refilled for a total period not to exceed 18 months from the date the veterinarian last examined the animal and prescribed the drug.
Also in California, recent Medi-Cal Rx News updates include the following:
• The Pharmacy Provider Self-Attestation Process has been extended through May 9, 2021, and has a new web address. If your company already submitted your self-attestation and received a confirmation email from CODSurvey@mercer.com, please disregard April 30, 2021, notice.
• Changes to the Contract Drugs List have been made effective May 1, 2021.
• Changes to the Contract Drugs List – Authorized Drug Manufacturer Labeler Codes have also been made effective May 1.
Lastly in California, the Medi-Cal Update Bulletin 990 – April 2021 includes the following items of interest. See bulletin for additional information.
• A new DUR Educational Article titled “Drug Safety Communication: Potential Increased Arrhythmia Risk from Lamotrigine (PDF)” is available on the DUR: Educational Articles page of the Medi-Cal website.
• Updates to the List of Enteral Nutrition Products effective for dates of service on or after March 1 have been made available.
• The MAPC per Unit of Measure for HCPCS code A4657 in The Medical Supplies Billing Codes, Units, and Quantity Limits spreadsheet has been corrected to ‘By Report”.
For more information, contact NACDS’ Sandra Guckian at 703-837-4195.
Florida
The Board of Pharmacy published a notice to amend regulations under FAC 64B16-31 to update the incorporated pharmacist licensure and pharmacy intern and technician registration forms.
Also in Florida, the Department of Health published a notice of a workshop to adopt regulations under FAC 64J-4 to establish requirements for the Prescription Drug Donation Repository Program. The workshop is scheduled for May 14, 2021, via video and teleconference.
For more information, contact NACDS’ Leigh Knotts at 803-408-9774.
Hawaii
HB 386, mandating the pharmaceutical industry fund a product stewardship program for the collection and destruction of unused drugs, failed to pass before adjournment of the legislature.
For more information, contact NACDS’ Sandra Guckian at 703-837-4195.
Kentucky
MedImpact will hold a series of informational webinars for providers to share information on the transition to a single PBM, which will be effective July 1, 2021. The seminars will be held on May 14, June 15, and July 15, 2021. For more information on the seminars and other information about the transition, click here.
For more information, contact NACDS’ Jill McCormack at 717-525-8962.
North Carolina
The Board of Pharmacy has issued guidance that allows for the pharmacist-manager to expand the pharmacist-technician ratio to 3:1 or 4:1 if in the judgment of the pharmacist-manager demonstrates that the pharmacy employs enough certified technicians to meet the ratio.
Also in North Carolina, the Board of Pharmacy has initiated rulemaking to expand the use of centralized processing for all pharmacies. The Board will hold a remote public hearing on July 20, 2021, at 10:00 am. Written comments will be accepted until July 20, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-408-9774.
Arkansas
Gov. Asa Hutchinson (R) signed into law SB 505/Act 651 legislation requiring prescribers to co-prescribe an opioid antagonist to patients under certain conditions: (1) dosage is equal to or above 50MME per day; (2) benzodiazepine has been prescribed or will be prescribed at the same time as the opioid; and (3) the patient has a history of drug abuse or a drug overdose.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The COVID-19 Vaccine Administration Frequently Asked Questions (FAQs) page previously found on the Medi-Cal Provider website has been divided into separate FAQs for providers and beneficiaries. These documents are available on the COVID-19 Medi-Cal Response webpage under the FAQs section. As a reminder, the Coronavirus (COVID-19) Uninsured Group FAQs are also available along with the providers and beneficiaries FAQs.
Also in California, the Department of Health Care Services launched its series of ongoing releases of enhancements, updates, and changes to improve and enhance its website navigation and user experience. A complete list of the enhancements, updates, and additional website changes can be viewed within the Medi-Cal Provider Website Release Change Log. Providers are also encouraged to subscribe to the free Medi-Cal Subscription Service (MCSS). The MCSS allows each subscriber to choose and tailor both the subject matters and types of communications they wish to receive from the Medi-Cal Program.
Lastly in California, the Board of Pharmacy recently distributed the following to licensees and stakeholders:
- Updated draft versions of self-assessment forms for pharmacies and wholesalers are now posted in addition to currently adopted versions on the Board of Pharmacy website. The Board is in the process of approving the draft versions through formal rulemaking. Board regulations require pharmacies and wholesalers to complete adopted versions of self-assessment forms. However, completion of either adopted or draft versions is acceptable. The Board believes updated draft versions provide a more helpful assessment of pharmacies and wholesalers. The drafts include references to statutory and regulatory changes that occurred between 2012 and the revision date of each draft form. Self-assessments must be performed before July 1 of every odd-numbered year. Completed self-assessment forms must remain at the facility unless the Board requests submission of the form. To find the forms, go to pharmacy.ca.gov. Under the “Licensees” tab, click on Facility License Information/Renewal and scroll down to the link for Self-Assessment Forms.
- The California State Board of Pharmacy extends its gratitude to all its licensees working to address the COVID-19 pandemic, including the most recent vaccination efforts underway in many pharmacies. As vaccine supplies continue to increase and vaccine eligibility expands, the Board would like to encourage pharmacies to plan appropriately when electing to provide COVID-19 vaccination services. Such planning should include:
- Ensuring sufficient staffing to maintain other pharmacy services while balancing vaccination services.
- Ensuring sufficient space to provide vaccinations safely, and sufficient space and chairs for patients to remain seated during the recommended period of observation.
- Ensuring appropriate staff is observing patients following administration of the vaccine.
- Ensuring vaccination appointments can safely be accommodated with the staffing resources available.
- In light of Governor Gavin Newsom’s declaration of emergency and the national declaration of emergency, and consistent with Business and Professions Code (BPC) section 4062, the California State Board of Pharmacy (Board) or the Board president through delegated authority has issued the following waivers.
- Mass Vaccination Sites
- Amended and Reissued: April 21, 2021
- Expiration: July 18, 2021
- Mass Vaccination Sites
- Supervision of Pharmacy Interns
- Effective: April 22, 2021
- Expiration: July 20, 2021
- Supervision of Pharmacy Interns
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
On April 24, the Pharmacy Sunset legislation pharmacies support that expands our scope of practice unanimously passed the Senate and is now pending further action in the House where we will push to have it scheduled in committee as soon as possible.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
House Bill 1405 PBM reform legislation NACDS supported led by Meijer passed the General Assembly and was sent to Gov. Eric Holcomb (R). There were multiple provisions important to pharmacies including (1) prohibitions on quantity or refill limits, (2) weekly MAC list updates, (3) notification to all pharmacies on successful MAC appeals and adjustments, and (4) established a formal complaint process for addressing MAC appeals and contractual issues.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The new Medicaid Provider Enrollment Portal designed to meet Centers for Medicare and Medicaid Services (CMS) requirements for screening and enrolling Medicaid providers and must be used by all Medicaid providers, including those who do not participate in fee-for-service will launch in June of 2021. The fiscal intermediary and current provider enrollment vendor, Gainwell Technologies, will send providers an invitation to the mailing address on file when it is time for them to visit the portal and complete the enrollment process. Providers can find additional information and submit questions on the provider enrollment webpage and in the Informational Bulletin 21-5: New Louisiana Provider Enrollment Portal
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
AB177, legislation pharmacies strongly oppose that mandates language translations be on the prescription vial passed the Assembly and is pending action by the Senate Health and Human Services Committee on April 29. The bill requires retail pharmacies to provide the information required to be included on the label of a prescription drug in English and, upon request of a prescribing practitioner, patient, or an authorized representative of a patient, any language prescribed by regulations adopted by the Board.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oklahoma
SB 4, legislation by Sen. Greg McCortney (R) establishing conditions when a pharmacist may substitute an interchangeable biological product for a prescribed biological product was signed into law by Gov. Kevin Stitt (R). The new law will take effect on November 1, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
On April 26, the House Public Health Committee approved both the immunization bill, CSHB 678 by Rep. Phil Cortez by a vote of 10-0 and the test and treat bill, HB 2049 by Rep. Donna Howard reported favorably without amendments by a vote of 9-0. NACDS members are urged to contact members of the Texas House of Representatives asking them to VOTE YES on both HB 678 and HB 2049. More information can be found here.
Also in Texas, last week, the Texas House passed its proposed two-year, $246 billion state budget after spending hours on controversial issues such as Medicaid expansion and school vouchers.
Lastly in Texas, the Board of Pharmacy is hosting a quarterly virtual meeting on Tuesday, May 11th at 9 AM. The agenda and conference information is available here – Texas State Board of Pharmacy
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The State Pharmacy Association’s (WSPA) bill, HB 1445 by Rep. My Lihn Thai (D), clarifies that the reconstitution and mixing of nonsterile products according to FDA labeling and according to a prescription, often referred to as simple compounding, is not compounding. The bill was signed by Gov. Jay Inslee and will go into effect on July 25, 2021.
Also in Washington, Gov. Jay Inslee (D) signed into law the Second Substitute to HB 1161 which modified the requirements for the manufacturer’s drug take-back programs under the Department of Health.
Also in Washington, Apple Health (Medicaid), administered by the Health Care Authority will implement changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program. on June 1, 2021. The full SMAC list can be found on the agency’s Provider billing guides and fee schedules website under the Prescription Drug Program and applies to claims billed FFS.
Also in Washington, HB 1127 by Rep. Vandana Slatter establishes privacy and security standards for COVID-19 health data passed both houses and was sent to Gov. Jay Inslee (D) to sign into law.
Also in Washington, the Health Care Authority (HCA) sent a Provider Alert informing providers about updates to the COVID-19 vaccine clinical policy regarding the roster billing for COVID-19 vaccine administration. When billing for vaccines for fee-for-service clients, there are three options:
- Bill each individual claim.
- Use batch 837.
- Template billing.
HCA is no longer requests that you bill the vaccine with the vaccine administration code. If you do submit a claim with both codes, HCA will not pay for the vaccine but will pay for the administration of the COVID-19 vaccine. These policies apply to both fee-for-service (FFS) providers and HCA-contracted managed care organizations (MCOs). For more information go to Apple Health (Medicaid) COVID-19 vaccine clinical policy under Reimbursement information and billing guidance.
Lastly in Washington, the Office of the Insurance Commissioner extended two Emergency Orders until May 16, 2021:
- Notice requires health insurers to waive copays and deductibles for coronavirus testing. It also requires insurers to allow a one-time early refill for prescription drugs; to suspend any prior authorization requirement for treatment or testing of Covid-19, and to allow enrollees to be treated by out-of-network providers within a reasonable distance at no additional cost when the insurer does not have enough in-network medical providers.
- Notice concerning insurance coverage for coronavirus diagnostic testing, prohibiting all health carriers from balance billing for Covid-19 diagnostic testing processed by out-of-network laboratories, when determined to be medically necessary. It also requests that insurers notify the agency if out-of-network laboratories submit claims but have not published a cash price or fail to accept such a price.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
On April 9, Gov. Doug Ducey (R) signed into law SB 1356 (Chapter 217, Laws 2021) prohibiting PBMs, from directly or indirectly, holding a pharmacist or pharmacy responsible for a fee related to the claims adjudication process, including adjudicating a pharmacy benefit claim, processing or transmitting a pharmacy benefit claim, developing or managing a claims processing or adjudication network or participating in a claims processing or adjudication network. Pharmacies may file a complaint of a violation, and a PBM that commits a violation is subject to penalties.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
NACDS and the Arkansas Grocers and Retail Merchants Association submitted a joint letter to the House Public Health, Welfare and Labor Committee urging the committee members to strongly oppose HB 1945 by Rep. Wooten. HB 1945, filed on April 19th would establish discriminatory restrictions on pharmacy ownership and prohibit chain pharmacies from operating pharmacy locations throughout Arkansas. The bill was heard in committee on April 22 and was pulled down and referred to further consideration after the session during the interim study. The legislature is scheduled to adjourn by April 30, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.